FORM1100-NBI                STATEOFDELAWARE
                                 DivisionofRevenue
                     CorporateScheduleofNon-BusinessIncome/Loss
Calendar year        or fiscal year ending

Federal Employer Identification Number

Corporation’sName

Address

  City                                State       ZipCode

Acorporationmayexclude,underlimitedcircumstances,“non-business”incomeandlosses(net
of related expenses) earned or incurred in the course of non-business activities unrelated to
those carried out in Delaware.

Anentryonthisschedulemustbesupportedbyidentifyingeachitemofnon-businessincomeby
descriptionandamountanddemonstratingforeachitemthat:

  (1)  Delaware is not the state of commercial domicile of the corporation. Commercial
       domicileistheprincipalplacefromwhichthetradeorbusinessofthecorporationis
       directedormanaged;

  (2)  Thereislackofaunitaryrelationshipbetweenthecorporationandthesourceofthe
       income. If the payor or other source and the corporation are at all functionally
       integrated,iftheyhaveanycentralizedmanagement,orif,betweenthem,theytake
       advantageofeconomiesofscale,thenthereisnotalackofaunitaryrelationship;

  (3)  The income at issue is of an investment, as opposed to an operational, nature.
       Interestearnedontemporaryinvestmentsofworkingcapital,oroninvestmentsmeant
       atmaturityoratalatertimetobeappliedtooperations,isofanoperationalnature;
       and

  (4)  Theincomeandapportionmentfactorshavebeenappropriatelyadjustedbyrelated
       expensesanditemsusedtoproducetheincome.

DESCRIPTIONOFNON-BUSINESSINCOME                     AMOUNT

1)

2)

3)

4)

5)

6)Total Non-Business Income/Loss            AttachThisScheduletoForm1100
  EnterthisamountonLine2(h),FORM1100
                                            *DF12114019999*
  (Revised 11/18/14)                                DF12114019999

                             INSTRUCTIONS FOR FORM 1100-NBI
              Corporate Schedule of Non-Business Income/Loss
Form 1100 NBI, Corporate Non-Business Income/Loss is designed to allow a corporate taxpayer to
eliminate from federal taxable income those items of non-business income or loss which are earned
or incurred in the course of NON-BUSINESS activities unrelated to those carried out in Delaware. In
general, the income or loss which is excluded from taxable income must result from purely passive,
investment, non-operational assets, and the activities which gave rise to such income/loss must be
carried out outside Delaware. Each entry on page 1 of this form must be supported by the following
documentation:
1) Address of the commercial domicile.

2) Name and address of the payor or source of Non-Business income.

3) Description of the relationship between the corporation and payor, or source of the income.
(“Source” includes a corporation, on the sale of whose stock, gain is recognized.)

4) For each payor or source, answer the following questions:
a) Are the payor or the source and the corporation functionally integrated?
b) Do the payor or the source and the corporation have centralized management?
c) Provide a list of the common officers and/or directors of the payor or the source and the
corporation.
d) For each payor or source provide a schedule (by percent of total goods purchased) of the
goods purchased from such payor or source.
e) For each payor or source provide a schedule (by percent of total services purchased) of the
services provided by such payor or source.
f) For each payor or source provide a schedule (by percent of total goods sold) of the goods
sold to such payor or source.
g) For each payor or source provide a schedule (by percent of total services provided) of the
services provided to such payor or source.

5) For each item of Non-Business Income, provide schedule of the underlying income which
provided the funding for such investment and a schedule of the disposition of the income
from such non-business income. It must be demonstrated that the income from non-business
activities does not fund, support or contribute in any way to business activities.

6) For each item of Non-Business Income, provide a schedule of adjustments to allocable income
and the apportionment factors.
The Delaware statute provides for the allocation of certain forms of income and for the apportionment
of the balance of entire net income. An adjustment must be made to the allocation and apportionment
items to the extent that such amounts are excluded as non-business income or losses.

                                          *DF12114029999*
(Revised 11/18/14)                                                DF12114029999